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Practicing Gratitude

This busy world is full of “To Do” lists and distractions galore. One thing that has really helped me gain a different and happier perspective is the practice of gratitude. My practice of gratitude is still a work in progress. However, I find that the more I work at it, the easier it gets. And the better I feel about myself and about those around me.

Rare moment of stillness as my children pose for the camera.

A few of the things I have started to do:

Physically writing down what I am grateful for. This helps use muscle memory and makes the items I am thankful for seem more real and hard to forget.

Thinking about things beyond my control, at the start of my day, and at the end. This helps me to frame my day, and also keeps me humble. I may feel like I can control a lot of things, but there is so much in life that is happenstance and chance. This is not something to bring fear or unhappiness. Rather, it should bring wonder each and every day. So much in this life is a blessing.

Best effort at a selfie with the kids. And yes, my daughter, Maddie, is enjoying a cookie in between takes. Priorities, priorities.

Go to bed each night thinking of my family. My family is undoubtedly the thing I am most thankful for. I smile and laugh to myself recounting some of the craziness and silliness that has happened that day. I try to capture some of this with photos and notes to myself. But it is amazing how many little memories are built each hour, each day, and each week. Time really does fly by. Today is a gift, and I try to live more in the present, rather than dwelling on the past or fretting over the future.

Future plans: A Gratitude Journal

These are my simple starting points, that have at least gotten the ball rolling for me. In time (perhaps as a New Years Resolution), I hope to start a gratitude journal. That should be a more concrete way to record some of my thoughts and feelings. It should be fun to look back on things I may have forgotten.

Gratitude: Turning Negative Thoughts Around

For now, though, I think what I have started has built a daily routine that changes my perspective for the better. It is easy to get down on things in the world and get down on myself when things are not going well. This approach of gratitude helps reframe my thoughts in a healthier and more productive way.

Recent date night with my best friend and husband. Definitely grateful for having him as my partner for life!

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Work and Life – A Balancing Act

I feel pulled in different directions each day: called to serve my family and also called to fulfill my career demands. I find that the following approaches have helped me find some peace and organization in my busy daily life.

Peppa Pig and pals – Striving for order in a disorderly world.

Writing Down My Goals

I physically write down my goals for the days and weeks ahead. I keep a journal and jot down thoughts before they escape. Each morning I try to focus on one or two achievable goals. Our modern lives are bombarded with constant streams of social feeds and updates. Having my goals written down keeps me focused and organized.

Keeping My Goals Short and Doable

If one of my goals remains on my list too long, it is often because the goal is too large, or I am not yet ready to achieve it. I think harder about how to reword the goal to achieve tangible results. I strive to break down bigger vague goals into quick achievable steps.

My shorty, getting bigger every day.

Setting Practical Deadlines

Having deadlines has made me more accountable and productive. After each of my goals, I set a reasonable “due date.” If the due date passes, I analyze where I may have went wrong in my estimations. Or, I think about what challenges may have come up to monopolize my time. I then choose a new deadline, taking into account my track history.

Re-strategize When I Don’t Reach My Goals

Life can get complicated and messy. Life does not always follow the course I want it to take. Sometimes traffic will make me late. Illnesses come up when I least expect it. Another emergency arises. This does not mean, however, that I need to throw away my plans or live a chaotic and disorganized life. Instead of looking at this negatively for too long, I consciously try to see the disorder of life as a challenge and a way to become better, stronger, and more resilient.

If life gives you livestock, why not go for a ride?

Practicing Gratitude Each Day

I strive to focus on 3 things in my life every evening that make me smile. There is so much I am thankful for. I have bad days interspersed with my good days, but regardless of what happened, I try to take 5 minutes in my evening to focus on what has brought me happiness and joy.

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Conquering An Injury

We have all had an injury, be it physical or emotional. My recent marathon training and first marathon included fortunately minor and self limited injuries – bruises, scrapes, strains, and sprains. In my day to day encounters with other people, disagreements and negative exchanges of energy crop up from time to time. From these encounters, I have suffered emotional bruises. I have honed my approach to injuries over the years, and broken it down into 5 steps. My approach has helped me cope and thrive, and I am happy to share my approach with you here.

It’s a rough and tumble world out there! With fun comes a risk of injury.

Acknowledge and name the injury.

Come up with a realistic plan for rehab.

Revisit your rehab plan regularly. If things are not going as you expected, adjust accordingly.

Return to your normal activities. Take a moment of gratitude for your return to normal activities, and your ability to heal from your injury.

Troubleshoot why the injury happened, and strategize ways to avoid the same injury in the future.

1. Acknowledge And Name The Injury.

This allows you time to comprehend and describe the injury to yourself. Physical injuries are often obvious. A scrape or abrasion of the skin. An evolving bruise. An ankle sprain causing pain and limping. More complex, however, are injuries and hurt under the surface. Overtraining and burnout. Hurt feelings. Disappointment at missing out on an opportunity. Anger when someone else has wronged you.

I recommend you take several minutes to yourself and ruminate over the injury. What is it that you feel? Why do you feel that way? Do not simply think negatively and take a “woe is me” attitude. “Well, I fell and now I have a big bruise on my knee. What will I do now?” Rather, better evaluate your feelings and response to the injury. What are your collections of feelings causing you to feel badly? What are the physical symptoms and emotional symptoms that you feel, and what was the sequence of events leading you to this?

Bad things befall all of us. Take a moment to acknowledge the injury.

2. Come Up With A Realistic Plan For Rehab.

Physical injuries are no fun. If you are training for a specific goal, they can seem insurmountable and goal ending. However, do not take such a quick, pessimistic approach before fully analyzing the situation. Where are you in your training? How long will it take to recover or heal? Is there a way to cross train through the injury, in say 3-4 days? How can you reasonably but safely return to your sport?

Emotional injuries are equally unpalatable. It may be wise to take 5-10 minutes to yourself to think through and meditate over your feelings. Also yourself to privately feel what you feel, on your own time. If you can, allow the feeling to burn out a bit before returning to your usual activities. Consider talking to those around you about what you are experiencing. Or consider journaling about your experiences right there on the spot or later in the day. Come up with a time period over which to feel what you feel.

With a problem, particularly an injury, analyze the pieces and try to put them back together.

For example, on my evening after a “bad day,” when I get a moment alone, I allow myself 15-30 minutes to think through what happened. I then try to push it down and use another 15-30 minutes to look toward the positives, and what I can do differently the next time. The next morning, if the negative situation returns to my mind, I set the thought aside and instead focus on my day ahead and think how I can do things better.

I find dwelling on the past too long, and what I cannot change, is harmful and counterproductive . I have instead taken a strategy of setting a time limit on my thoughts, and then think more of the present and my future actions.

3. Revisit Your Rehab Plan Regularly. If Things Are Not Going As You Expected, Adjust Accordingly.

I try to do this every few days or every week as I am in my rehab plan. It helps me assess my progress objectively, e.g. “I feel 70% back to normal. ” I then see if I can adjust my return to full activity sooner or later than I expected. This constant assessment and adjustment is helpful not just with injuries but other aspects of your life. For example, I use this when I assess my spending plans or my progress in paying off my debts.

As you “drive” through your plan, analyze the journey you have made and how far you have come. Make any necessary tweaks to your path to ensure success.

4. Return To Your Normal Activities. Take A Moment Of Gratitude For Your Return To Normal Activities, And Your Ability To Heal From Your Injury.

When you feel ready, go ahead and make the leap! Go back to the activity you enjoy. Do not simply rush back into what you love. I find it helpful to briefly appreciate how I was able to heal and overcome the injury I had a few days or a few weeks before. Practicing gratitude is a great habit, particularly when celebrating your accomplishments.

When you are ready and healthy, return to your activity with a vengeance (and a smile)!

5. Troubleshoot why the injury happened, and strategize ways to avoid the same injury in the future.

As a scientist and engineer, I like to analyze systems and why things are running the way they are. I particularly try this analysis when things are not going smoothly. For example, if you feel burnout and excessive fatigue, try to analyze why. How much are you training? How much sleep are you getting? Has your nutrition been satisfactory or poor? Once I write down some of the factors that I feel led to the injury, I try to come up with ways to prevent a repeat injury. In the example above, I would re-analyze my sleep patterns, and work to get to bed 10-15 minutes earlier each night until I felt more rested.

The Rollercoaster of Life

I hope the tips I have shared will help you as you work through your next injury. Please feel free to share your own strategies for overcoming obstacles in your own life!

Life is full of ups and downs. Take time to enjoy the rollercoaster of life, and how you can make your experience better.

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My First Marathon is in the Books!

I completed my first marathon in Columbus, Ohio on October 15, 2017! I feel blessed and fulfilled with my accomplishment. I finished in 4 hours, 31 minutes, and 3 seconds. My goal was to finish at 4 hours and 30 minutes, so right in line my goal! The weather was warm and humid, but only a brief several minute drizzle late in the race.

The starting line. I was in the last Corral of the race – waiting at the back of the pack for my chance to start!

My months of training served me well, not only in my physical stamina but also in conquering my mental game as well. 26.2 miles is a long time to be inside of your head. The first 13.1 miles was crowded with half-marathoners, thousands of welcome distractions from my discomfort.

The second half was much less crowded, and was truly a mental challenge, not just for my increasing pain and fatigue but also questioning my goal and my ability to carry out the race. Due to challenges of working full time and fitting in training for a marathon, I had only completed a 17 mile long run in my training.

Can you feel the race day excitement?

As I got past the 17 mile marker, I rejoiced at my success but also wondered if I could make it 9 more miles to the finish line. I concentrated my energy on pushing these negative thoughts aside. I consciously replaced these thoughts with the reminder the cumulative fatigue I had endured with my training. I would repeat to myself “You’re good. You’ve got this.” (Sometimes I would whisper it to myself as well.) The 50-60+miles of running a week increased my endurance and ability to withstand the challenge. The crowds of fans and volunteers were also amazing and full of positive talk to keep me going.

My Number One Fan

My husband was the most wonderful support for me during the race. He was my companion and chauffeur, and my #1 cheerleader. But more importantly, he was supportive and understanding during my hours of training for the 5 months leading up to the race. Running 40-50+ miles a week takes a lot of time and commitment for the athlete, but is also trying to the athlete’s loved ones. Several hours spent running means less time for your loved ones and other pursuits. My husband’s support behind the scenes was invaluable and necessary for my success with my running hobby.

Rest and Recovery

I am currently in my 2 week period of rest and recovery, with a leisurely and enjoyable return to running. I am catching up on much needed sleep and quality time with my family. I am reminiscing about the hours I devoted to not just the race itself but also the 20 weeks leading up to the race. I am so happy that my first marathon experience was a success!

My two beautiful children – two smiling reminders of why my life is full of joy and happiness!

My next running goal will be this spring: The Pittsburgh Marathon on May 6, 2018!

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Working More Efficiently

Feel like you are constantly turning your wheels, running on an unforgiving treadmill of life? I hope these three tips will help you feel more efficient as you tackle your day!

We all want to end our day feeling fulfilled. As a working mom, I want my every action to count for good, be it with my family, friends, or my patients.

I recently read a post by Dr. Rebekah Bernard about burnout in women physicians. If you haven’t read it and you are a female physician, it is definitely worth a read. Even if you aren’t a female physician, though, it is an empowering article to challenge you to change your situation for the better.

Dr. Bernard’s words inspired me to write this piece on 3 tips I have used in my own life as I strive for a more efficient and happier work day.

3 Tips for a Better Work Day

Planning your time. Live each day as it comes, but plan not only the day to come, but also the weeks and months on the horizon.

Touch each item once. Be decisive in your tasks.

Keep work at work. Or at least, do this as much as you can.

Each day involves all kinds of challenges, but remember we all cycle around the sun once every 24 hours, to start over again tomorrow. I hope these 3 tips lead to better productivity in your day.

1. Planning your time.

You can go into each day without a clear game plan, and come out okay. However, having a loose framework personally helps me accomplish more and also leave work at the end of the day with a sense of purpose. I also feel that planning each workday, week, and month will give you a feasible and realistic way to accomplish your various tasks.

The following 3 steps outline how I strategize my work day:

A) Arrange the skeleton of your workday first with things you must do (for example, get kids up and dressed, shower, drive to work, activities after work).

B) Look at your daily schedule in terms of things that may be different (for example, my patient schedule varies, or you may have meetings on Tuesdays and Thursdays). You can then pencil these into your day.

C) Create a list of tasks you need to get done and tasks you want to get done, and allot a bit of time for each of them. You can then fit them into your day in time slots where you are unscheduled. For example, you have a 30 minute block of time between arriving at work and before your first meeting – here you can plan to do a chunk of your paperwork (e.g. complete half of the paperwork on your desk). You should prioritize the “need to do” tasks, and then the “want to do” list should gets pushed down lower on your list.

Don’t forget to plan for your commute!

I try to approximate how long each task will take (for example, answering 2 messages should take me about 5 minutes; addressing 10 emails should take me about 8 minutes total). I have come to realize over time that I underestimate tasks, so I add some wiggle room (e.g. adding a minute or two), particularly when I am tired, stressed, or feeling under the weather.

I break up huge tasks into smaller doable ones. For example, I may come in Monday morning with 10 refill requests. I set a goal for myself to complete 2 refills before seeing my first patient, and then filling 2 more after each of my patients when I get a couple minutes of down time.

This planning system works for me, and I do it loosely in my mind as I go through my day. It takes practice, but the more you do it, the more it becomes second nature. And doing things this way makes you feel more in control of your day, and less like that huge task list owns you and is going to defeat you.

You are of course welcome to write everything down. I do write down things on my Google Calendar, and I tried in the past to write things down for a few days, but I find that being too regimented gets stressful when I get behind.

Try to plan for all of life’s ups and downs.

Another tip for you to arrange your life is to plan to use a spare hour or two on your weekends to plan weeks and months ahead. For me, this usually involves planning my hobbies, my husband’s hobbies, vacations, family activities. These things I do write down, as juggling multiple calendars gets confusing. I have also started setting goals for myself with my health and fitness, finances, and vacation/rest. Writing these down helps to set you up for success.

Plans do not have to be set in stone, but having things loosely “penciled” down helps you get things out of your mind and somewhere out there in the real world. While doing this exercise, I realize that sometimes my goals are a bit lofty, and I need to break them down into more doable chunks. Getting your wishes written down and arranged in the weeks and months ahead will make them more real and achievable.

I also realize as you are doing this planning that unfortunately things do NOT always go your way. Illnesses will come up. A family emergency will arise. I try to be adaptable and less rigid with my schedule when this happens. The list of “things to do” and “things that are nice to do” will always be there, but that does not mean they are a must.

When an emergency arises, you should take 30-60 minutes to problem solve as soon as you are able, and determine what absolutely must be done, and what can wait. Once this is prioritized, you can break down where to fit each of the tasks you must do. You can write down the leftover things that must wait, and try to strategize when you could next complete them (e.g. next week on your day off, or next weekend when you do not have any plans).

Work hard, but be sure to find time to relax and “enjoy the ride”!

One other piece of advice: do not overextend and overschedule yourself. You need to learn to say “no” to things that do not matter to you. If you have more free weekends and free time built into your schedule, these inevitable disasters that arise will not totally derail your life. You will have an extra evening, an extra Saturday morning, a spare Sunday afternoon here or there to “catch up.”

2. Touch Each Item Once.

Be decisive. This is a must if you want to get your day running smoothly, and keep yourself sane.

I have seen this tip time and again in several articles on working more efficiently. I am a perfectionist and “Type A” in my drive to do the best and most accurate work I can do. This allows me to thrive and do good work, but it is also detrimental when I am agonizing over things that really do not matter. I grammatical error in my note, or a small typo in punctuation really are very minor.

Enjoying sunshine and fun on the Boardwalk.

I have learned over time to “let things go” and it has really helped in my ability to get my messages and emails written, and my progress notes done. I also remember in residency agonizing over decisions. I would save a lab result or a message in my Inbox for several hours or a day or two, agonizing over what to do. Really, however, my first gut instinct would be the course of action I would take.

My habit now is to set myself up to truly touch things once. Once I have opened up an email, I look up what I need to look up, think of a viable answer, and send it on. I sometimes try to think through all of the possibilities (What if the patient wants this or that? What if they say no to my proposition? What if they say yes?!)

I have struggled to be less complete and thorough, and be more succinct in my work. Doing this relieves a lot of stress, and is more efficient as well. It is okay to be quicker and shorter with your actions. The person you are working with will reply, and guide your further action. You do not have to think of every possible scenario and plan for it. It only matters what this scenario will prove to be. Let life guide you where you need to go.

Keep Work at Work (As Much as You Can)

I strive to do this more and more in the last few years as my husband and I have built our family. My priority in life is to have a happy and healthy family, and feel fulfilled in the work I do. To do this properly, however, you need to have boundaries.

Starting out in residency and medical school, I was a work-a-holic. I would study often. I would stay up late. I would feel always behind, always catching up. I carried this over into my attending position after residency. And this is not a healthy way to live and work. I felt driven but unhappy.

Hibachi grilling (FIRE!) brings a matching pair of smiles to these guys’ faces. What makes you happy?

As I have gotten older (and hopefully wiser), I have realized that life is more important than the work you do. I have learned to set healthier boundaries on my work life, and I feel happier with each and every limit I set. A great exercise I encourage you to do: write down 3 important things in your life. I guarantee keeping a clean inbox at work is NOT one of them. Why then, do we all strive to do this every day?

Over the last year, I have worked hard to keep my nose to the grindstone, focus at work, and work hard. I try to set a limit on how late I stay, for example, try to leave by “X-oclock” and get home. It helps to have an activity lined up (for example, I need to leave by 5:30 pm to pickup the kids at daycare), which often leads me to working more efficiently than I would have otherwise.

I also have worked hard to schedule short 5-10 minute breaks in my day. I have read several articles alluding to this, and I find it very much true. The old adage “All work and no play makes Jack a dull boy” definitely has some merit to it. If I stick it out and try to work straight for 40 minutes in a row, I find I am much less efficient. Taking just a 5 minute walk around the office helps to clear my head and boost my resolve to get more work done, in a quicker amount of time.

Yes – your work messages (and phone calls) can follow you home. Don’t let it get you too bogged down. Set some limits.

Being practical, however, I realize there are bad days or bad weeks when nothing goes your way. There will be times you get behind and need to catch up a bit at home. If you must do work at home, set a time limit and schedule it for a time when it won’t interfere with your family time.

My personal approach to working from home is scheduling chunk of time to finish my documentation or answer emails for a 1-2 hour block of time on a Saturday or Sunday evening. I then analyze my efficiency and see how accurate I was in my estimate of time. If I am off, what created the inefficiency? Hunger, fatigue, trying to multitask instead of single tasking, network slowness, shotty Internet connection?

Whatever caused the inefficiency in the past, write these down and try to

Know when to hold ’em. Know when to fold ’em. Know when to take a nap! Take care of yourself, so you can care for all you love.

account for them the next time you must work from home. This will create a more accurate number. And if it is something you can circumvent (e.g. eating a snack to start with, or taking a nap before), do so.

“Catching up” from home is something I now try avoid like the plague, and you should too. I am happier because of this. If you must catch up and work from home, keep this intrusion in your life as short and efficient as possible.

You also should be honest with yourself before scheduling this into your free time. If you really have something else you “need” to do (catching up on your DVR, answering texts, etc), do those first, and then save the work for another, shorter chunk of time.

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My Favorite Running Gear

A good pair of running shoes and comfortable clothes are necessary to succeed at running. I have found seven other “nice to have” items to make your runs even better.

In the last year of training, I have ramped up my running slowly and steadily. At first, I was running a mile 3-4 times a week and huffing and puffing. Now, I am averaging 50 miles+ week, and feeling confident and proud of my progress. I spent the first 5-6 months training for my first half marathon, and the last 5-6 months were devoted to training for my first marathon. (My Columbus marathon is coming up very soon, on October 15!)

My happy family, supporting me through my long training months!

The 7 running gadgets and tools below have been very helpful and valuable. These are the ones I use daily and truly love! I have sequenced these from least complicated/least expensive to those products that are more pricey, but (in my humble opinion) worth the higher price tag.

Body Glide

Running Vest

Buddy Pouch

Milestone Pod

Road ID

Run Angel

FitBit

1 Body Glide

A must for long runs, particularly if you have areas that chafe and rub. Go for a long run on a hot day, and you will know which areas apply to you. Body Glide is pretty affordable and worth the investment- I buy mine on Amazon for about $10-$15.

2 Running Vest

This is a must to stay visible if you run in early AM or late evening, when the lighting is not ideal and you are less visible to drivers. They come in various designs and colors. My running vest cost me about $15 on Amazon.

When the lighting is minimal or nonexistent outside, preserve your visibility with a bright vest!

3 Buddy Pouch

I have tried the arm bands and the fashionable “fanny packs.” I don’t like how the arm bands rub on my arms and when I am wearing wired headphones, it can be awkward. The fanny packs also rub and slide, and bounce when I run. This Buddy Pouch, however, is really sleek and attaches to the waist of your pants with magnets. If you have contraindications to a magnet (e.g. pacer/defibrillator) this is not an option. Otherwise, though, if this does not exclude you, I think this is a well designed and reasonably priced product. It comes in several sizes. I got an extra large sized Buddy Pouch (big enough to hold my phone, snacks and keys) for about $25 on Amazon.

My daughter’s not-so-tiny pumpkin buddy. The Running Buddy is much sleeker and more user friendly than this!

4 Milestone Pod

This is a really neat device to analyze your running metrics. It attaches to the laces of your shoes, and tracks your gait and the miles you have run. There are other products out there that do similar work, but I like this one for its low cost and usable app interface. I have not tried the other products out there, but I think this product, is worth the cost to give a go. The Milestone Pod costs approximately $30 (on Amazon). (You may see running theme here with my recommendations. I admit – I am an Amazon Prime addict).

I have definitely seen an improvement in my stamina and comfort levels with running as I have used this product. By analyzing things such as my cadence, stride length, and ground contact, I have steadily altered my running style for the better. I run more upright, with quicker, shorter steps. This is not only more efficient, but more comfortable and more sustainable, allowing me for longer, happier runs.

5 ROAD iD

I bought this later on in my training after worrying more and more about my safety and “what if” I had an accident or became unable to speak for myself. I decided to a buy a product that fits right on my FitBit band. It lists my name, birth year, and contact info for my husband. Not only does it give me some confidence running, it also gives my husband some peace of mind. There is also an option for an extra subscription for a tracking app . This extra tracking feature allows me to send an alert to my husband about where I am running and how long I will be out. It also will send an alert to my husband if I am stationary for longer than 5 minutes. My RoadiD was about $30, and arrived in about 2 weeks.

6 Run Angel

I bought this product after reading online accounts of others who have been taunted or assaulted while running alone. I prefer to run alone, mainly for convenience of my schedule and I like to be alone with my thoughts while I run. The Run Angel is a wrist band with a loud 120dB alarm that is triggered by me pushing a button. Once I trigger this alarm, it will also alert my “angel” (my husband, in my case) that I am in danger. It was a bit pricey, shipping from the company which is based in Ireland. There is an offer for 15% off of your first order if you provide your email. It cost me about $100. I think this is a worthy investment for some peace of mind.

7 FitBit

My husband bought my Charge 2 for me about a year and half ago, and I wear it daily. I had a FitBit Flex a few years ago, but I prefer the Charge 2 due to a bigger display and more tracking options. I like how it tracks not only my steps and miles, but also the elevation I have climbed per day, measured in flights of steps. The app is user friendly and offers options to follow and compete with your friends. This is one more way to keep you disciplined and motivated in your exercise and training. My Charge 2 currently retails for about $150.

Happiness as a kid is…jumping on a trampoline, without a care in the world! My FitBit gives me fitness data daily which makes me happy as well – not quite as happy as these little ones, but as happy and satisfied as can adult can be.

A Few of My Favorite Things

These are a few of my favorite running things. Now, of course, you should invest in a pair of comfortable, reliable shoes and comfortable breathing running clothes to start with. But these additional “nice to have” accessories are my personal favorites that have made my runs more comfortable and fun.

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My Dreaded Student Loans

Like many young physicians, I am carrying a huge student loan balance from medical school. The training to become a physician is not only tedious and mentally and physically demanding, it also bears a hefty price tag. To make matters worse, the interest rate for federal student loans for professional school were (and continue to be) quite lousy, 6.8%. The professional school loans dropped a bit since I graduated, but have creeped back up to the 6% range.

I needed to borrow a bit more than my allotted direct federal student loan, to cover my costs. This extra loan took the form of a “Grad Plus” loan with even worse interest rates in the 7.6% range, if I remember correctly. (Fortunately, I have paid these off a few years ago, and so I no longer recall the exact interest rate.) It seems like an impossible task to pay it all off, while also investing in my retirement accounts and paying my other day to day bills.

Medical School costs HOW much?! Yowza!

Slow But Steady Progress

In spite of these challenges, I have looked back at my account balances over the years, and I have been buoyed to see a steady improvement. This has improved not just my financial health, but also my mental health and happiness.

As those out there who also suffer with debt can understand, I quickly try to forget where my accounts have been (maxed over $230,000 June 2011, at the time I graduated medical school). However, I think it is important not to neglect where things started. Taking an “eagles eye” view of things and looking back at the numbers of the years has really opened my eyes to my accomplishments .I love seeing how that balance has dropped! And once I get that balance to “0” and defeat my loans, I will be doing a happy dance and cruising on Cloud 9 for days, if not longer!!!

Happiness is…paying off debts and playing on huge Fisher Price toys!

5 Easy Tips to Defeat Your Student Loans

The following 5 tips have helped me build momentum as I payoff my student loans. I believe they will help you succeed as well!

Make a payoff plan. Adapt as you go along!

Minimize new expenses.

Put your loan payments on Autopay.

Put extra money toward your loans each month.

Track and celebrate your payoff progress!

1. Make a payoff plan. Adapt as you go along!

I decided in my 4th year of medical school that I would start to payoff my loans in residency. I had an option to defer but I realized that this would simply raise my loan burden, as loans start to accrue interest once you graduate from medical school.

In my 3rd year of residency, as the promise of an attending salary drew closer, I sat down and came up with a plan to payoff my loans faster. Paying off my loans in 20 years sounded unappealing, so instinctively, I decided to apply more money to my goal. In the last couple of years, I have encountered other financial blog sites recommending similar strategies to what I employed.

My plan consisted of putting an extra amount each month to my Grad Plus loans first. I then strategized to payoff each of my subsequent loans, paying off the highest interest rates first, and then tackling the lower interest rate loans. I downloaded a loan amortization Excel spreadsheet from the web, and calculated the time it would take me to pay each loan off. This made things tangible, as I was able to see a date of loan payoff. Always helpful to have a finish line!

However, just because I had a plan, this did not mean I have stuck to it without swaying. I have constantly revisited my plan and tweaked it as I have been able. When I first graduated from medical school in 2011, refinancing was not a viable option. However, in the last several years, student loan refinancing has been introduced. I have refinanced my loans twice, and have lowered my rates to 6% and then 4%. If you have not yet explored refinancing, and you are toting 6.8%+ rates, you should seriously consider this. It will save you tons in interest and will help you payoff your loans faster!

Swing into your loans with a smile… and a plan!

2. Minimize New Expenses

You should come up with a spending plan or Budget if you haven’ yet. I know, I hate that B word too. But you need to know how much income is coming in, how much expenses are going out, and what the difference is. You want a net positive each month. Whatever that net positive is, is leftover for saving and (**insert Rocky theme song here**) loan payoff.

(Note If you have more expenses than income each month, this is the first problem you need to tackle. Going further and further into debt is not healthy nor sustainable. Stop this process ASAP!)

The biggest detractor from your plan will be too much spending, and taking on new loans. Tracking your spending, spending mindfully, and sticking to a budget is the best way to ensure success in your long term goal of paying off your loans and debts.

I personally use Mint to track my spending and budget, but any of the websites are great. Or you can use the old fashioned pen and notebook to track your income. Whatever your method, check your budget at least monthly to make sure you are staying on track.

3. Put Your Loan Payments on Autopay

Autopay is a must. This ensure you pay your bill on time and avoid late fees. Of course, if you are living paycheck to paycheck and do not yet have a nice cushion in your checking account, this can be anxiety provoking. However, my loans take the payment right on the due date anyway. You will need to have the necessary payment at that point in time, so nothing to lose.

This option takes you out of the equation as well. Things can go along smoothly, and there is one less bill for you to remember each month. Because of this simplicity, Autopay is something to strongly consider with other fixed bills each month. Also, as a bonus, the lender often will give you a small break in interest percentage for taking this option on. A few of my lenders have given me 0.25% interest discount. Awesome!

Cruise your way to an easier life with Autopay!

4. Put Extra Money Toward Your Loans Each Month

In addition to the money I had set in my payoff plan each month, I also strive to put any leftovers each month to my loan. I take surveys from time to time, get rebates from my rewards credit cards, use eBates for online purchases, and I subscribe to InboxDollars and MyPoints. These opportunities give me little bonuses irregularly. Sometimes a $5 check, sometimes $20 or more. Unfortunately these are not as regular (or as big) as my paycheck. These seem small, but they are valuable and appreciated. There always seems to be an extra expense that crop up from time to time as well, vying for these extra dollars. Vacations, Christmas, birthdays, parties, medical bills, activity fees. The list goes on and on.

When I am lucky to have money leftover and an extra expense does not come up to snatch my wealth away, I sit down at my computer and make another online payment to my loan. It hurts to do this, “Wow, there goes that money into “the sinkhole that is also known as my loan.”” And it seems there is nothing tangible to show for it. No Starbucks cup of coffee to greet me. No cool Amazon package on my doorstep. However, later in the weeks and months that follow, this little work pays off. As you chip away with each extra payment, the loan balance will drop slowly but steadily. This is an amazing thing to behold!

5. Track and Celebrate Your Payoff Progress!

I have created a note on my computer, with 2 columns: the date and my loan balance on that date. I started doing this when I read another post advising you to write down your loan amount on a sticky note and placing it somewhere prominent that you will look at each day (e.g. your mirror). This really solidifies it and makes it real. No more excuse like “oh yeah, there is this big ugly number that follows me from medical school, but it is only something I think about when I login to the website.” Seeing it each morning in a real, tangible form is hard, but also makes you more determined to attack and conquer. I found that listing the date and balance over time is also very gratifying. It is neat to see how the number slowly and steadily drops, and how it can drop even faster with extra payments. This motivates me even further to stick to my budget, and put a little extra to my loans when I can.

Savor hummus… and your successes!

Go out and Defeat Your Loans!

So there you have it. A handful of the things that I have found success with in my student loan battle. My loan payoff saga is still ongoing, and my finish line is still a bit in front of me. But I find every small drop in my balance as incredibly inspiring and motivating. I wish you success in your own battle to slay your student loans!

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The Start of My Love Affair with Running

I have gravitated toward distance running since high school. I played soccer and also joined my high school track team, opting for the longer 3200 kilometer race. My tendency toward endurance sports likely means my body has more “slow twitch” fibers. Or perhaps I have a penchant for long, grueling processes. Whatever the case, I continued to run both in high school, and afterward.

Later, in college, I joined Naval ROTC, where running was a key part of “PT” (physical training) sessions and a component of the physical fitness test. I loved how much I improved with regular training exercises with my battalion. I also am a perfectionist and a habitual practicer, so I would run on the side to improve my performance at the PT sessions. This, of course, improved my physical fitness even further, and led me to further enjoy running.

Falling off of the Wagon, i.e. my Time Away from Running

My little nugget of Turkey energy, Madelyn, around 15 months of age. In the time period between my daughter’s birth and my son’s birth, I felt progressive fatigue. Kind of like I had just eaten a large Thanksgiving dinner, suffering the hangover effects of Tryptophan!

As I transitioned to medical school and then residency, busy life took over. I blamed my degree of stress and overwork on why I fell off of my beloved hobby. However, as I have mentioned in other posts, I now realize I was also suffering from Graves Disease, which caused exercise intolerance, shortness of breath upon exertion, and palpitations. I was unaware of this, thinking I was simply “lazy” and busy, and blamed the symptoms on poor conditioning and lack of willpower.

My Return to Running, with a Vengeance

Fast forward now to fall 2016. This was the time of my Graves Disease diagnosis. Once the diagnosis was made, I realized my fatigue had a secondary cause. My mind was blown. And also, my confidence grew. I resumed running here and there. And then, January 1, 2017, I made a “New Years Resolution” to run the Pittsburgh Half Marathon. The longest I had run to that point was probably in the ballpark of 3-5 miles. I was nervous but also excited to challenge myself, and see how far I could go.

I carried out the training dutifully, finding a free beginners training plan online. I entered the workouts into my calendar, and tried to juggle these around my already busy life. The first couple of weeks were pretty rough, I will not lie. I admit I was embarrassingly out of shape. But I persevered, primarily because I had set a goal. I had also registered for the race furthering my commitment. Internally, as well, I did not want to shortchange myself – I wanted to know if I could do it, and do it right!

I finished my first half marathon at age 35 in 2:23. Not too bad for my beginner-level training and several years of couch potatoed-ness preceding this!

A couple of days after finishing, I was incredibly sore. I got Delayed Onset Muscle Soreness with a vengeance, mainly because I did not train on hills leading up to this hilly race. I did not incorporate any strength training into my Half Marathon training. I also ran faster in the race than I had been training (the adrenaline made me do it!). However, mentally, I was buoyed and very proud of my accomplishment.

About 2 days after my race ended, I was motivated to next take on a marathon. I logged on that day to the Columbus Marathon website and (wisely or unwisely) registered myself. My very first marathon will be in Columbus, Ohio, this October, 2017.

I have been training for this marathon now for 3 months. I have a little less than 2 months to go before my race date. The training is grueling and time consuming. I will admit it is not all gumdrops and rainbows. I have good days, and bad days! I have also begun more strength training this time around, as I have read several books and articles highlighting why it is important to be a well rounded athlete.

I admit I neglected strength training altogether with my Half Marathon training, as I am busy and like to cut corners where I can. But incorporating about 10 minutes/day of body weight strength training most days of the week has improved my health, my sense of accomplishment, and my physical fitness. I think my physique has also improved. All of those smart trainers and exercise physiologists are correct – it pays off to be well rounded!

Thought the training is hard at times, I have come to look forward to my runs. I have also opted to move my runs to the morning. This ensures I get the workout done. I also feel accomplished and more productive early on in my day. The runs are a time for me to focus on me. I push my body with my harder runs, and let my subconscious take over with my easier runs. It is cathartic, a form of mindfulness and meditation for me nearly every day.

My husband, Matt, and son, Luca, two of the reasons that I want to keep fit and healthy each and every day!

Why Should You Exercise?

Now, I realize not everyone enjoys running. But I think there is something everyone’s body is inclined to doing, be it walking, swimming, cycling, etc. I challenge you to start doing this regularly, for example, 4-5x/week for 10 minutes a session at first. Pencil it in (electronically or physically) into your calendar. This will hold you accountable. You will feel guilty ignoring the event, or worse, scratching it off or deleting it. I also encourage you to consider working out in the morning. As I have mentioned, it gets the workout over and done. Also, your mind will be stimulated by the physical activity so early on in the day. I suspect you will perform better and be happier with the rest of your work and life activities later that day.

My daughter, Madelyn, one of the beautiful reasons I live a happy, fulfilled life!

Most importantly of all, exercising regularly not only helps your mental health, it also improves your physical health. You will have lower risk of heart disease, stroke, and diabetes. With the rising overweight and obesity epidemic in our society, I think these are all unfortunately becoming too commonplace in my day to day practice as a family physician. Please do your darnedest to avoid these diseases! It is so much better to avoid the diseases altogether, than to try to treat them once they are present. Part of your risks come from genetics, age, and sex, which I realize are not changeable. However, your physical activity and exercise habits are something you CAN change. Please do so!

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My Old Companion, Anxiety

I had anxiety. I am very glad and fortunate that anxiety is no longer a constant part of me. I have been nervous and worrisome since my childhood. However, I had poor insight into the fact of how problematic this was. I assumed that the things I felt were what everyone else was feeling. I would get “butterflies” in my stomach each morning, particularly worse with school or work. When driving, this feeling of “flip flops” in my gut would happen each time I would anticipate a terrible accident when other drivers would turn or cut in front of me.

As a physician, when I patient would propose a challenging problem or symptom, I would feel the anxiety building in my mind and in my stomach. Speaking in front of crowds would create intense panic. I was so busy and hard headed to recognize that I was experiencing was pathologic. Now, however, I am blissfully anxiety-free. It took the absence of this nagging specter of anxiety for me to realize it for what it was.

My Thyroid Gland

How can this be, that my anxiety is now thankfully gone? I have a condition called Graves Disease. This is an overactivity in the thyroid gland, which is a butterfly-shaped gland that controls metabolism and growth. I was diagnosed with this in the fall of 2016, after evaluation for worsening fatigue. I was placed on oral medication for about 8 months. About 3 months into treatment, my fatigue had considerable lessened. In addition, however, and totally surprisingly to me, the anxiety I had been feeling my entire life had disappeared.

Mama – This is getting boring! Move it along, please!

What is anxiety?

The medical definition of anxiety, per Merriam-Webster, is “an abnormal and overwhelming sense of apprehension and fear often marked by physical signs (such as tension, sweating, and increased pulse rate), by doubt concerning the reality and nature of the threat, and by self-doubt about one’s capacity to cope with it”.

Wow. I wish I had looked this definition up sooner, and connected the dots in myself. However, if you do not realize you are having a problem, why would you seek out a solution? I am dabbling in the concept of mindfulness and meditation in the last few weeks. If you start adopting this practice, you will become more in tune with your own symptoms. I hope that by practicing mindfulness and meditation, you will be able to recognize when something is out of balance, and seek appropriate help.

I am so grateful for my improvement with my own therapy. Looking back, I realize that coping with my anxiety all of those years taught me ways to be resilient. I learned to focus and cope through the intense physiologic response of stress. However, I would never go back to the way I felt all of those years. I feel so much more balanced, calm, and free.

My family and me at Idlewild in fall 2016, right before my diagnosis. I am so grateful for my good health, and my ability to fully appreciate and enjoy those I love!

If you also suspect that you have anxiety (or any other condition, for that matter) I encourage you to seek evaluation by a medical professional. The first step is recognition that something is wrong. This is often intuitive, feeling something out of sorts. The job of your provider is to then deduce from your symptoms what is plaguing you. If you are currently struggling with something causing you distress, I hope that you also reach peace soon, so you may achieve balance in your work and your home life.

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Looking on the Positive Side

I have been looking more consistently at the “optimistic” side of things lately. And it has totally turned my day to day activities around, for the better! Instead of dreading a long tedious day at work, I look at the positives, with each minute and each hour. How can I help my next patient? What things can I learn from him or her? What makes this fellow human being interesting and valuable? Also, I look inward every now and then and take stock in what accomplishments I have made. Look at how far I have come! Several years into practice, I now have the experience and confidence to make decisions that I would agonize over for several minutes.

What about all the Bad Stuff Out There?

I know, I know, you read or watch the news and you cannot help but see all of the negativity out there. You sometimes cannot help but yield to the pessimism that surrounds us. But, it really matters how you perceive and look at things, since your attitude has a huge bearing on how you feel. I also think that having this positive outlook will improve your gratitude and thankfulness for all of the good in your life. And this will make you a better person!

Me and Luca. This little guy always manages to get me smiling and thankful!

I credit my more positive attitude to my binge-listening of “Optimal Living Daily,” a free podcast that reads short clips from various personal development blogs out there. Totally digestible, as they are short chunks of high yield information. I wish I had found this earlier! This is a great way to break up your morning commute. I personally add them to my morning workout playlist, which makes my workout breeze by. I also am addicted to Optimal Finance Daily, another offering from the Optimal Living Daily creators. These short clips from financial blogs will help improve your financial health. Please try them out!